Chapter 25 : Impact of Conjugate Pneumococcal Vaccine on Antibiotic Resistance

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Impact of Conjugate Pneumococcal Vaccine on Antibiotic Resistance, Page 1 of 2

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The fact that vaccinating infants and young children reduced drug-resistant (DRSP) disease and the carriage of pediatric DRSP serotypes in adults serves as the most compelling and definitive proof that children are responsible in a large part for the transmission of DRSP in the community. In a study to find out the efficacy of the conjugate pneumococcal vaccine against pneumococcal invasive disease caused by DRSP, 19,922 infants received pneumococcal conjugate vaccine (PCV) 9 and 19,914 received a placebo. Another study conducted by the Centers for Disease Control and Prevention (CDC), used laboratory-based active surveillance in multiple representative areas in the United States (the Active Bacterial Core Surveillance) to measure invasive diseases caused by DRSP from 1996 through 2004. The study by Byington and coworkers suggests that invasive pneumococcal infections with nonvaccine serotypes that are nonsusceptible to penicillin are increasing. The changes in proportions of pathogens isolated in cases of severe and refractory AOM before (1992 to 1998) and after (2000 to 2003) the introduction of universal vaccination in rural Kentucky were documented. The proportion of isolates decreased from 160 of 336 (48%) to 26 of 83 (31%) and the proportion of isolates increased from 137 of 336 (41%) to 46 of 83 (56%). Since antibiotic use selects for and promotes antibiotic resistance among strains, an important question is whether the use of PCVs can reduce antibiotic use.

Citation: Dagan R, Klugman K. 2008. Impact of Conjugate Pneumococcal Vaccine on Antibiotic Resistance, p 369-385. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch25

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Pneumococcal Conjugate Vaccine
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Figure 1

Pulsed-field gel electrophoresis fingerprint patterns and dendrogram of SmaI restriction digests of representative isolates of 26 Pneumococcal Molecular Epidemiology Network clones. Reprinted from http://www.sph.emory.edu/PMEN/pmen_clone_collection.html with permission. (Courtesy Leslie McGee, Emory University.)

Citation: Dagan R, Klugman K. 2008. Impact of Conjugate Pneumococcal Vaccine on Antibiotic Resistance, p 369-385. In Siber G, Klugman K, Mäkelä P (ed), Pneumococcal Vaccines. ASM Press, Washington, DC. doi: 10.1128/9781555815820.ch25
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